Youritrecruiter UM Nurse role involves conducting clinical reviews to assess medical necessity and efficiency of services requested by providers and members. It supports the health plan’s utilization management aligned with clinical guidelines and accreditation standards.
The position uses criteria such as MCG and InterQual for inpatient, outpatient, and ancillary reviews, aiming to deliver cost-effective, high-quality care and regulatory compliance.
#J-18808-LjbffrUtilization Management RN – Clinical Review & Cost Control in Location not specified at Unknown Company
- Typical pay
- $71,760–$121,680
For context, most registered nurses earn between $71,760–$121,680 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and onsite.